| NPI | 1669015129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 88001587A) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: IN 19-103379) |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2022-04-19 |